Provider Demographics
NPI:1477667798
Name:IMPERIO, EMERLINDA (NP)
Entity Type:Individual
Prefix:
First Name:EMERLINDA
Middle Name:
Last Name:IMPERIO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 YAWPO AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-2739
Mailing Address - Country:US
Mailing Address - Phone:201-337-3412
Mailing Address - Fax:201-337-3353
Practice Address - Street 1:19 YAWPO AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-2739
Practice Address - Country:US
Practice Address - Phone:201-337-3412
Practice Address - Fax:201-337-3353
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR07326300363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ088847M24Medicare UPIN